Session Information

Background/Purpose: Calcium supplements are prescribed for prevention of osteoporotic fractures, but excess intake has been associated with cardiovascular events. The most adequate tools for estimating dietary calcium intake are time-consuming, while an accurate estimation is a prerequisite to be able to prescribe the adequate amount of supplementation. The aim of this study is to validate a Short Calcium Intake List (SCaIL) that is feasible in daily clinical practice, with an extensive dietary history (DH) as reference method.

Methods: Based on the Dutch food groups which contribute most to daily dietary calcium intake and on portion sizes determined in our earlier validation study, a new three-item, one minute SCaIL was designed. As a reference method, an extensive DH with specific focus on calcium products and extra attention for portion sizes was performed. Beforehand, a difference of ≥250 mg calcium between both methods was considered clinically relevant.

Results: Sixty-six patients with either primary (n=40) or secondary (n=26) osteoporosis were included. The SCaIL showed a very small and clinically non-relevant difference with the DH: mean 24 ± 350 mg calcium per day (1146 ± 440 vs 1170 ± 485, respectively; p=0.568). Sensitivity and specificity of the SCaIL, compared to the DH, were 73% and 80%, respectively. However, in 50% of the individuals, a clinically relevant difference was observed between both methods, while in 17% a difference of ≥500 mg was observed.

Conclusion: The SCaIL is a quick and easy questionnaire to estimate dietary calcium intake at a group level, but is not sufficiently reliable for use in individual patients. Remarkably, mean dietary calcium intake via the DH is 1170 mg per day, which indicates that a large proportion of osteoporosis patients might not even need calcium supplementation.